Apple Cider Vinegar, Does it Work?8/19/19
TV doctors and health “gurus” would have you believe that apple cider vinegar is the next “superfood” that will cure all that ails you. And, it’s easy to fall for the hype around apple cider vinegar, especially when people start selectively quoting studies to impress upon you just how important the liquid is to your health and wellness.
But, what’s the truth?
Is apple cider vinegar everything it’s cracked up to be, or is it just another empty promise to the masses?
Before we answer that question, let’s briefly explain what apple cider vinegar is for those who may not be aware.
What is Apple Cider Vinegar?
As its name states, apple cider vinegar is a type of vinegar.
Vinegar comes from the French “vin aigre”, which means sour wine.
Apple cider vinegar is made by crushing apples and then squeezing out the liquid (juice) from the mash. This liquid is collected and has yeast (bacteria) added to the liquid to catalyze the fermentation process.
During the initial fermentation, the natural sugars in the apple juice are converted to alcohol by the yeast and bacteria. Following this, a second fermentation takes place where the alcohol developed from the first fermentation is subsequently converted into vinegar by acetobacter, which yields acetic acid.
Acetic acid along with malic acid (which also is naturally found in apples) gives the vinegar its renowned tart, sour flavor.
Pasteurized or Not?
In your local grocery store, you’ll encounter two main types of apple cider vinegar -- pasteurized or unpasteurized.
The big difference between the two forms (aside from undergoing pasteurization or not) is the presence of “mother” -- a combination of yeast and bacteria formed during the fermentation process.
It is this “mother” to which many of the advertised health benefits of apple cider vinegar are attributed. Keep in mind, however, that the pro-health benefits of the “mother” have yet to be fully elucidated in the research, though the “mother” is considered a source of probiotics.
Similar to other vinegars, such as white distilled vinegar, apple cider vinegar contains trace amounts of vitamins, minerals, amino acids, including sodium calcium, phosphorous, sodium, potassium, chlorine, magnesium, iron, and B vitamins.
Now that we’ve covered the basics on all this ACV, let’s see what (if any) research-backed benefits may exist.
Research-Backed Benefits of Apple Cider Vinegar
May Help Regulate Blood Sugar
Type 2 diabetes, metabolic syndrome, and obesity are rampant, showing no signs of stopping amidst the general population. One common feature of all three diseases is chronically elevated blood sugar.
A number of studies have been conducted to assess the effects of vinegar consumption on postprandial (after meal) blood glucose levels. Now, most of these studies use plain, white vinegar, as opposed to apple cider vinegar.[1,2,3,4]
However, a couple studies have used apple cider vinegar, and the results are encouraging.[5,6]
In the first study, participants consumed a meal composed of a bagel, OJ, and butter, containing a total of 87 grams of carbohydrates.
After the meal, the subjects consumed either a placebo or vinegar treatment (20 g apple cider vinegar, 40 g water, and 1 tsp saccharine). The researchers checked the subjects’ blood glucose levels 30 and 60 minutes after eating the meal and found that the vinegar group had significantly lower postprandial blood glucose levels.
The second apple cider vinegar study of note had subjects consume either 2 tablespoons apple cider vinegar or 2 tablespoons of water with 1 ounce of cheese prior to bed.
The following morning, researchers measured the subjects’ blood glucose levels and found that the apple cider vinegar had blood glucose readings 4-6% lower (on average) than the placebo (water) group.
The bottom line here is that apple cider vinegar may not be the cure for high blood sugar levels and diabetes, but it may help maintain more stable blood sugar levels following a high-carb meal.
May Enhance Weight Loss
Next to “detoxing”, weight loss is the most common reason people start experimenting with apple cider vinegar.
Similar to our previous section, a number of studies have found that regular vinegar (acetic acid) ingestion, not cider vinegar, may prevent fat accumulation and increase fat oxidation (fat burning).[7,8]
The catch here is that those two studies were done in rats...not humans.
However, a pair of studies have assessed the effects of apple cider vinegar in conjunction with a reduced-calorie diet on weight loss in humans.
The first study involved 155 obese Japanese subjects and found a dose-dependent response in those who consumed apple cider vinegar. More specifically, the group who consumed 30ml of apple cider vinegar lost 1.9kg of weight compared to the placebo who experienced no change in body weight.
Another group consumed 15ml of vinegar (about 1 tablespoon of cider vinegar) and experienced a weight reduction of 1.2kg (~2.64lbs).
Now, it should be mentioned that this study had the participants self-report their food intake, which is known to be highly inaccurate as most people underestimate how much food they actually eat.
A second randomized-control trial, published in 2018, had subjects drink one tablespoon (15ml) of apple cider vinegar with lunch and dinner for a total of 2 tablespoons of vinegar per day.
Both placebo and vinegar groups also consumed a reduced-calorie diet that was 250 calories less than their TDEE.
At the end of the 12-week study, researchers noted that the vinegar group lost over 8 pounds (on average), while the placebo group only lost 5 lbs (on average) over the 12-week study. Interestingly, the researchers also observed the vinegar group also had a reduction in cholesterol levels too.
The takeaway here is that adding two tablespoons of cider vinegar to a reduced-calorie diet may have modest benefits on fat loss, but not so potent that it erases the need for you to train hard or adhere to a calorie deficit.
Does Not “Detox” the Body
Just flip on any daytime TV doctor show or pick up some random “health” magazines off the shelf at the grocery store and you’re guaranteed to encounter the latest fad diet guaranteed to detox your body and accelerate your weight loss journey.
Apple cider has been, and remains, a prominent member of the detox diet schtick.
Included amongst the ways that apple cider vinegar has been touted to detox, cleanse, and purify the body is its high acidity and low pH level.
But, here’s the thing, the liver and kidneys are the body’s natural “detox” system. And, provided you’re a reasonably healthy individual with no history of kidney, liver, or GI disease, these organs will eliminate any nefarious microorganisms and toxins that try to “pollute” your body.
Moreover, a 2015 critical review concluded that there was ZERO evidence that detox diets help eliminate toxins from the body.
In other words, neither apple cider vinegar nor any other food will “detox” your body.
May or May Not Delay Gastric Emptying
One of the mechanisms by which apple cider vinegar has been theorized to reduce appetite and support weight loss is by delaying gastric emptying.
Essentially, some researchers believe that consuming apple cider vinegar alongside a meal may help increase the amount of time it takes food to travel through the GI system, which increases feelings of fullness, helping you stop eating sooner, and thereby consume fewer total calories.
However, other research disputes these findings as researchers conclude the weight loss-enhancing effects of apple cider vinegar are attributed to neither reduced starch digestion (carb absorption) or delayed gastric emptying.
The jury is still out on whether or not apple cider vinegar will help slow digestion. More research is needed to solidify its effects on gastric emptying.
Does Not Block or Reduce Carbohydrate Digestion & Absorption
As we just mentioned, apple cider vinegar quite frequently is marketed as a “carb blocker”, meaning apple cider vinegar prevents your body from fully digesting and absorbing a portion of the carbohydrates you eat.
However, research has shown that consuming apple cider vinegar does NOT interfere, reduce, or limit the amount of carbs your body digests or absorbs.
The bottom line here is that any claims you see about apple cider vinegar acting as a carb blocker are unfounded according to the latest research.
Does Not Lower Blood Pressure
Another popular claim regarding apple cider vinegar consumption is that it can help combat high blood pressure, a.k.a. hypertension. This belief stems from a small animal study which found that when rats consumed acetic acid (white vinegar) they had a small reduction in blood pressure.
However, these findings have not been replicated in healthy human subjects or those with high blood pressure. The myth is that ACV can be used for controlling blood pressure.
Does Not Cure Cancer
A few isolated cell culture studies have found that vinegar may possess some anti-cancer properties. However, cell cultures where you directly pour vinegar on cancerous cells are a far cry from drinking a tablespoon or two of vinegar each day.
There are some epidemiological studies investigating the link between vinegar ingestion and cancer, but the results are mixed.[15,16]
Therefore, any claims you may encounter regarding the anti-cancer properties/benefits of vinegar consumption are ambiguous...at best.
The Bottom Line on Apple Cider Vinegar
Apple cider vinegar makes for a tasty addition to salads and roasted veggies, and it may also help support healthy blood sugar levels as well as weight loss.
It can even be used as an “all-natural” cleaner, due to its high acid content.
However, apple cider vinegar is far from a miracle cure, detox agent, or quick fix weight loss supplement.
If you enjoy the taste of apple cider vinegar on your food, feel free to keep using it, but if not, you’re not missing out on anything tremendous.
- Ebihara K, Nakajima A: Effect of acetic acid and vinegar on blood glucose and insulin responses to orally administered sucrose and starch. Agric Biol Chem 52: 1311–1312, 1988
- Brighenti F, Castellani G, Benini L, et al: Effect of neutralized and native vinegar on blood glucose and acetate responses to a mixed meal in healthy subjects. Eur J Clin Nutr 49: 242–247, 1995
- Sugiyama M, Tang AC, Wakaki Y, et al: Glycemic index of single and mixed meal foods among common Japanese foods with white rice as a reference food. Eur J Clin Nutr 57: 743–752, 2003
- Johnston CS, Buller AJ: Vinegar and peanut products as complementary foods to reduce postprandial glycemia. J Am Diet Assoc 105: 1939–1942, 2005
- Johnston, C. S., Kim, C. M., & Buller, A. J. (2004). Vinegar Improves Insulin Sensitivity to a High-Carbohydrate Meal in Subjects With Insulin Resistance or Type 2 Diabetes. Diabetes Care, 27(1), 281 LP – 282. https://doi.org/10.2337/diacare.27.1.281
- White AM, Johnston CS. Vinegar Ingestion at Bedtime Moderates Waking Glucose Concentrations in Adults With Well-Controlled Type 2 Diabetes. Diabetes Care. 2007;30(11):2814 LP-2815
- Kondo, T., et al., Acetic acid upregulates the expression of genes for fatty acid oxidation enzymes in liver to suppress body fat accumulation. J Agric Food Chem, 2009. 57(13): p. 5982-6.
- Fushimi, T. and Y. Sato, Effect of acetic acid feeding on the circadian changes in glycogen and metabolites of glucose and lipid in liver and skeletal muscle of rats. Br J Nutr, 2005. 94(5): p. 714-9.
- Kondo, T., et al., Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Biosci Biotechnol Biochem, 2009. 73(8): p. 1837-43.
- Khezri, S. S., Saidpour, A., Hosseinzadeh, N., & Amiri, Z. (2018). Beneficial effects of Apple Cider Vinegar on weight management, Visceral Adiposity Index and lipid profile in overweight or obese subjects receiving restricted calorie diet: A randomized clinical trial. Journal of Functional Foods, 43, 95–102. doi:10.1016/j.jff.2018.02.003
- Klein, A.V. and H. Kiat, Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet, 2015. 28(6): p. 675-86.
- Hlebowicz, J., et al., Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterol, 2007. 7: p. 46.
- Salbe, A.D., et al., Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects. Nutr Res, 2009. 29(12): p. 846-9.
- Johnston CS, Gaas CA. Vinegar: medicinal uses and antiglycemic effect. MedGenMed. 2006;8(2):61. Published 2006 May 30.
- Shimoji, Y., et al., Extract of Kurosu, a vinegar from unpolished rice, inhibits azoxymethane-induced colon carcinogenesis in male F344 rats. Nutr Cancer, 2004. 49(2): p. 170-3.
- Radosavljevic, V., et al., Non-occupational risk factors for bladder cancer: a case-control study. Tumori, 2004.90(2): p. 175-80.